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The review also examines an association between CAA and subdural hematoma (SDH), highlighting how SDH may signal increased hemorrhagic risk and complicate clinical management through discussed mechanisms such as vascular fragility and chronic 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Rosario Pascarella 2,4  \nAcademic Editor: Bingmei Fu andYe Zeng  \nReceived: 1 December 2025  \nRevised: 17 December 2025  \nAccepted: 20 December 2025  \nPublished: 23 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Neurology Unit, Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123 Reggio Emilia, Italy  \n2 SINdem Study Group “The Inflammatory Cerebral Amyloid Angiopathy and Alzheimer’s Disease Biomarkers”  \n3 CAA and AD Translational Research and Biomarkers Laboratory, School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy  \n4 Neuroradiology Unit, Ospedale Santa Maria della Misericordia, AULSS 5 Polesana, 45100 Rovigo, Italy  \n* Correspondence: [zedde.marialuisa@ausl.re.it or marialuisa.zedde@gmail.com](zedde.marialuisa@ausl.re.it or marialuisa.zedde@gmail.com)  \nHighlights  \nWhat are the main findings?  \n• This study identifies the potential involvement of the dura mater and its lymphatic system in the pathophysiology of Cerebral Amyloid Angiopathy (CAA), suggesting that these structures may play a role in the clearance of amyloid-beta (Aβ) and maintenance of cerebrospinal fluid homeostasis.  \n• The research highlights a significant association between CAA and subdural hematoma (SDH), indicating that patients with CAA may face an increased risk of hemorrhagic complications, which complicates their clinical management.  \nWhat are the implications of the main findings?  \n• Recognizing dural involvement in CAA emphasizes the need for further investigation into the role of meningeal lymphatics in amyloid clearance and cerebrovascular health, potentially leading to novel therapeutic approaches.  \n• Understanding the connection between CAA and SDH may guide clinicians in monitoring and treating patients more effectively, particularly in identifying those at higher risk for hemorrhagic events and adjusting management strategies accordingly.  \nAbstract  \nCerebral Amyloid Angiopathy (CAA) is a neurovascular condition characterized by the accumulation of amyloid-beta (Aβ) in the walls of small blood vessels, particularly affecting the leptomeninges and cortical regions in elderly populations. Initially recognized for its association with spontaneous lobar intracerebral hemorrhage, recent studies have highlighted the broader implications of CAA on cognitive decline and vascular health. This narrative review aims to elucidate the mechanisms of dural involvement in CAA, an aspect that has been largely overlooked in existing literature. This paper provides a detailed examination of the potential role of the dura mater and its associated lymphatic system in the clearance of interstitial amyloid and the maintenance of cerebrospinal fluid (CSF) homeostasis. Dural lymphatic vessels may facilitate the efflux of Aβ from the brain, and any impairment in this drainage system could contribute to the pathological accumulation of amyloid, exacerbating CAA and its neurological consequences. Additionally, the significant association between CAA and subdural hematoma (SDH) has been explored, indicating that the presence of SDH may complicate the clinical management of CAA patients by signaling an increased risk of hemorrhagic events. The mechanisms linking CAA and SDH,  \nincluding vascular fragility and chronic inflammatory processes, are discussed to provide insight into potential pathways for therapeutic intervention.  \nKeywords: cerebral amyloid angiopathy; CAA; sural; ICH; subdural; SDH; lymphatics; CAA-related inflammation  \n1. Introduction  \nCerebral amyloid angiopathy (CAA) is defined by the deposition of amyloid β (Aβ) in the walls of small arteries, arterioles, and capillaries locate","cbCaio7PXbAOeFGw","https://ap.wps.com/l/cbCaio7PXbAOeFGw","pdf",1765605,25,"English","# Highlights\n## Main findings\n## Implications of main findings\n# Abstract\n# Keywords\n# Introduction","[{\"question\":\"What does the review propose about dural involvement in CAA?\",\"answer\":\"It proposes that the dura mater and its lymphatic system may participate in CAA pathophysiology by supporting amyloid-beta clearance and maintaining cerebrospinal fluid homeostasis.\"},{\"question\":\"How is CAA associated with subdural hematoma (SDH)?\",\"answer\":\"The review highlights a significant association between CAA and SDH, suggesting patients with CAA may face higher risk of hemorrhagic complications, which affects clinical management.\"},{\"question\":\"Which mechanisms are discussed to connect CAA with SDH?\",\"answer\":\"The review discusses mechanisms including vascular fragility and chronic inflammatory processes as potential pathways linking CAA and SDH and informing therapeutic intervention.\"}]","Mechanisms of Dural Involvement in Cerebral Amyloid Angiopathy | PDF",1790769663,63]